It’s been just over two months since I started my second course of accutane. It doesn’t feel that long ago since I was sat in a cafe – jawline full of painful cystic acne – writing my first blog post about why I’m choosing to go on accutane again. Yet, at the same time, this past few months have gone so damn slowly and, at times, each day has felt like a week.
With that said, let’s get into the nitty-gritty details. Here’s my two-month accutane update 🙂
My dosage
For the first month and three weeks, I was on a low dose of 20mg accutane per day.
On this dose, my skin wasn’t too dry at all, and even my lips were manageable. The problem? I just wasn’t seeing much progress, especially on my closed comedones (of which I have many).
This wouldn’t necessarily be a problem under normal circumstances. The ‘low and slow’ approach is more common these days, as it gives people a chance to clear their acne using accutane without the harsh, often debilitating side effects. With a low dose, you still get the clear skin eventually – it just takes longer.
However, my skin was (and still is, tbh) impacting my mental health so much, that we decided it would be beneficial for me to speed up the purging and subsequent clearing. For that reason, in the last week of the second month, I went up to 40mg per day.
The side effects
It’s accutane… of course I’ve gotta write a paragraph about the side effects. But honestly, on 20mg, generally, my side effects were fine.
I did have the standard dry lips and some flaking around my mouth, but that was totally expected. After all, accutane literally shrinks your oil glands. I also had weird dry skin on my ear lobes, but that resolved on its own after a while. Oh, and I had nose bleeds. Major nose bleeds. I’m prone to nose bleeds anyway, but accutane has made them even worse.
Now, on 40mg, I’ve got all the same side effects, but just a little worse. I struggle to wear makeup without it peeling off mid-way through the day. Plus, the dryness has spread to my body. My arms are so rough and flakey. My ears are literally bleeding inside from being so dry. Still, it’s all expected on accutane.
Purging & results
I wish I could tell you my skin had miraculously cleared, but unfortunately, that’s not the case. With that said, it’s pretty normal not to see results on accutane in the first couple of months – some people are just super lucky.
I’d say my skin stayed the same for the first couple of weeks. No better, no worse. Just consistent breakouts around my jawline in particular. But then, as time went on, it worsened. The frequency of the breakouts increased and some of them were super inflamed, especially along my jawline as shown in the image below.
Thankfully, Dr Divya at AcneClear prescribed me a low dose of prednisone, a steroid, to help calm the purge down – especially as I was due to be a bridesmaid at one of my best friend’s weddings. That helped a lot and got my skin into a calmer state for the wedding.
The downside? After stopping the steroid, it flared up again. It carried on that way through the first two months, even spreading up to my cheeks. My acne wasn’t severe compared to many people’s purges, but it was still stressful for me.
It’s only now (the first week of the third month) that my skin seems to be calming down slightly, so I’m hoping that means the next update will be much more positive.
Experience with AcneClear
As I discussed in my first accutane blog, I’m doing my treatment with AcneClear this time. Last time, I went through the NHS, but this time, I really wanted to start my treatment as soon as possible due to the impact my skin was having on my life and wellbeing.
Before I started, I had to do a blood test at home. It was actually pretty easy, despite Jack standing in my kitchen literally looking like he was milking my finger for blood – if someone had have looked in the window, I reckon they’d have called the police. Ha.
Alongside this, I had to do a pregnancy test and send the results to AcneClear. I wasn’t pregnant (obv) and my bloods all came back fine, so I was fine to start the meds. This all happened in the span of a couple of weeks, whereas last time, I had to wait months on end for my initial consultation.
Plus, the bloods/pregnancy/consultation process was so much easier than it was last time, which involved multiple trips to hospital and peeing in a cup several times and handing it to my dermatologist – ha.
Since starting, I’ve had two (virtual) check-ups with Dr Divya, who is super lovely. We discussed how the treatment was going, how I was feeling, and my side-effects. We eventually decided to increase my dose because of my mental health (and the impatience for clear skin that came along with it), which I really appreciated.
So, so far, all good with AcneClear. If you want to find out more, check out their website, Instagram, Facebook or TikTok.
My mental health
A couple of months prior to accutane, my mental health started going downhill because my skin was flaring up so badly. Since being on accutane, it’s worsened.
Still, I wanted to put this under a separate heading to ‘side effects’ because, honestly, I’m not entirely sure that the decline in my mental health is because of the accutane itself. Personally, I think it’s because my skin got worse when I started accutane; and my skin getting worse, made me feel worse.
My skin is my major trigger. A good skin day means a happy Alice and a bad skin day means a panicky, insecure, obsessive Alice. It’s sad, but it’s the unfortunate truth at the moment.
After having acne for so long, I’ve developed OCD and body dysmorphic disorder. I’m not just throwing those around – I’ve recently been diagnosed. For me, this looks like constant mirror checking, picking at my skin in an attempt to remove the imperfections, over-reliance on make-up, incessant research in a bid to find a cure, and overwhelming feelings of sadness about my skin and general appearance.
I’ve now started the anti-depressant sertraline and am in therapy for these issues, so I’m really hoping that in time, I’ll be in a much better place. I’ll be writing more about this, and everything I learn during my therapy; so if you’re experiencing similar, keep an eye out for those.
Tips for accutane
I don’t want these blogs to be all about me, so just in case anyone is reading this who is on accutane too (or considering it), here are a few things I’ve learnt during my first month.
Firstly, drink more water. Okay, I already knew you had to drink a lot of water on accutane – obv. But over the past week or so, I decided to really go for it with the water. Instead of 2 or 3 litres per day, I’m aiming for 4. Although this means I’m weeing a lot (ha, at least it makes for easier pregnancy tests, I guess?!), I’ve noticed I feel less headachey and, overall, better. So, if you can, it’s well worth increasing your water intake.
Secondly, some skincare finds. I’ve recently started using hypochlorous spray and – omg – I love the stuff. I have a bad habit of picking at my skin (it’s part of OCD and I’m trying desperately to stop), and this stuff is so helpful for healing wounds. I spray it on before I go to bed, let it dry and then apply the rest of my skincare. I’ve noticed any marks/scabs are healing so much quicker now. I use BrioTech from Amazon, but the Tower 28 spray is super popular too.
I’m super scared of the thicker, accutane-recommended moisturisers (think CeraVe and Cetaphil) clogging up my skin, as I’ve had a bad time with closed comedones recently. For that reason, I’m focusing on hydrating in layers of lighter, less-cloggy products. My skincare currently includes:
- Wash with Geek & Gorgeous Jelly Joker (this is super gentle, which is exactly what you want on accutane)
- Spritz of BrioTech Hypchlorous Acid (wait for this to dry down)
- Geek & Gorgeous Liquid Hydration (no need to wait for this to dry)
- iUNIK Beta Glucan Serum (so light, but great for wound healing)
- Geek & Gorgeous Hydration Station (a moisturiser that’s free from silicones and fatty alcohols, so great for clog-prone skin)
- ZitSticka MegaShade SPF 50 (so many SPFs clog me up, but this one is specifically made for acne-prone skin)
At night, I slug with pure Vaseline after the Hydration Station. Most people think Vaseline is pore-clogging, but the molecule is actually too large to clog the pores. It’s actually a very safe way for acne-prone gals and guys to seal in moisture without the risk of causing a breakout.
I’ve also been going heavy on the pimple patches to stop me from picking. You can get mega cheap ones off Amazon, but I find they don’t stick as well. If you’re looking for some reliable ones, I love the Rheal Patches, the Purito Cica Patches and the Mighty Patches. If you have large clusters of breakouts, you might find the Large Mighty Patches useful too. I’ve literally been going out with the huge ones on my face, and if anyone asks, I just say it’s an injury lolol.
Thirdly, make sure you’re taking your accutane with a source of fat. It significantly increases absorption, which for you, could mean better long-term results. I have mine with breakfast, as I add a really generous handful of nuts, chia and flax seed to my yoghurt bowl, which gives me around 20g of unsaturated, healthy fats.
That’s all from my second month update. I’ll write another one in a couple of months, but if you want to keep up with my journey in the meantime, make sure to follow me on Instagram. If you’re going through accutane too, feel free to send me a DM and we can chat. Much love to everyone xxx
3 responses to “Accutane two month update: Results, side-effects & mental health”
I really appreciate your process blog and I hope things improve soon. I am in a similar boat, I have done 2 months at 10mg and just started 20mg last week and my skin has been awful the whole time. It’s my first time taking accutane. My skin looks even worse now an is really dry and painful. 😣
I’m in a same sex relationship so my derm is ok with me not being on the contraceptive pill during my course, but my ovulation acne is still a big problem. I worry that I chose the wrong treatment and I should have tried spironolactone, but I will ask my derm about it. Ugh 😩 why is hormonal acne so frustrating to treat!
Wishing you well, your skin looks great to me, and a lot more hydrated than my dry ass face 😂 I bought Cetaphil in the tub but have been scared to use it anywhere but my under eyes. 🙈
Really enjoyed reading this Alice, it was very informative and super helpful. It was very honest and your articles are so well presented. I don’t suffer from acne as bad as I did 13/14 years ago but it still has its little battles!
Thank you for sharing such a real and detailed two-month update it truly highlights both the challenges and progress of the accutane journey. Beyond medical treatment, supportive skincare plays a key role in managing dryness, sensitivity, and healing. At Food Research Lab, we help brands create scientifically formulated cosmeceutical products that enhance skin barrier repair, hydration, and overall tolerance during therapies like these. We help Cosmeceutical Product businesses solve this at FRL. Happy to connect!